Healthcare Provider Details

I. General information

NPI: 1508855131
Provider Name (Legal Business Name): BUIS DEL MAR PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 07/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9008 E. GARVEY AVE. STE #A
ROSEMEAD CA
91770-5306
US

IV. Provider business mailing address

9008 GARVEY AVE STE A
ROSEMEAD CA
91770-3370
US

V. Phone/Fax

Practice location:
  • Phone: 626-927-9773
  • Fax: 626-927-9838
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY47040
License Number StateCA

VIII. Authorized Official

Name: MS. THUY HONG (ROSE) THI BUI
Title or Position: CORPORATE OFFICER
Credential: PHARMACIST
Phone: 626-927-9773